Pedagogical reflective practice of nursing undergraduates: the portfolio as an instrument

Objective Analyzing the narratives related to the pedagogical practice experienced during the Supervised Curricular Internship reported in the portfolios of Nursing undergraduate students, regarding the levels of reflection. Method This is a documentary descriptive exploratory study that examined two of the activities proposed for the portfolio preparation. Results Among the 28 analyzed portfolios, all showed the three levels of reflection (technical, critical and metacritical). Conclusion The students had the opportunity to experience the pedagogical practice and presented reflections at metacritical level, reflecting on their performance, the construction of their teaching identity, and about the importance of reflecting on the practice with the objective of transforming it and transforming themselves.

The Tea4-PP1 landmark promotes local growth by dual Cdc42 GEF recruitment and GAP exclusion.

Cell polarization relies on small GTPases, such as Cdc42, which can break symmetry through self-organizing principles, and landmarks that define the axis of polarity. In fission yeast, microtubules deliver the Tea1-Tea4 complex to mark cell poles for growth, but how this complex activates Cdc42 is unknown. Here, we show that ectopic targeting of Tea4 to cell sides promotes the local activation of Cdc42 and cell growth. This activity requires that Tea4 binds the type I phosphatase (PP1) catalytic subunit Dis2 or Sds21, and ectopic targeting of either catalytic subunit is similarly instructive for growth. The Cdc42 guanine-nucleotide-exchange factor Gef1 and the GTPase-activating protein Rga4 are required for Tea4-PP1-dependent ectopic growth. Gef1 is recruited to ectopic Tea4 and Dis2 locations to promote Cdc42 activation. By contrast, Rga4 is locally excluded by Tea4, and its forced colocalization with Tea4 blocks ectopic growth, indicating that Rga4 must be present, but at sites distinct from Tea4. Thus, a Tea4-PP1 landmark promotes local Cdc42 activation and growth both through Cdc42 GEF recruitment and by creating a local trough in a Cdc42 GAP.

The impact of Economics on health policy and management in Spain

BackgroundDespite the intrinsic value of scientific disciplines, such as Economics, it is appropriate to gauge the impact of its applications on social welfare, or at least Health Economics (HE) case- its influence on health policy and management.MethodsThe three relevant features of knowledge (production, diffusion and application) are analyzed, more from an emic perspective the one used in Anthropology relying on the experience of the members of a culture- than from an etic approach seated on material descriptions and dubious statistics.ResultsThe soundness of the principles and results of HE depends on its disciplinary foundations,whereas its relevance than does not imply translation into practice- is more linked with the problems studied. Important contributions from Economics to the health sphere are recorded.HE in Spain ranks seventh in the world despite the relatively minor HE contents of its clinical and health services research journals.HE has in Spain more presence than influence, having failed to impregnate sufficiently thedaily events.ConclusionsHE knowledge required by a politician, a health manager or a clinician is rather limited; the main impact of HE could be to develop their intuition and awareness.

Comparació de tres mètodes per a violí : Shinichi Suzuki, Paul Rolland i Mimi Zweig

Aquest treball és un anàlisi de tres aproximacions pedagògiques en el camp de la música sorgides al segle XX; la de Shinichi Suzuki, Paul Rolland i Mimi Zweig. Les tres estan centrades en l’ensenyament del violí i formen part de les aproximacions pedagògiques més conegudes i amb més reputació en aquest camp. S’han volgut estudiar i analitzar de manera separada cada una d’aquestes aproximacions i, posteriorment, fer-ne una comparació que permeti observar aquells aspectes que comparteixen i aquells amb els quals difereixen. La conclusió extreta és que el coneixement de diferents aproximacions pedagògiques i l’adequada combinació d’aquestes, a l’hora d’impartir la nostra tasca com a docents, és el que ens enriqueix com a pedagogs i també com a persones.

Endoscopic Approach and Management of Parasellar Lesions

The parasellar region is the location of a wide variety of inflammatory and benign or malignant lesions. A pathological diagnostic strategy may be difficult to establish relying solely on imaging data. Percutaneous biopsy through the foramen ovale using the Hartel technique has been developed for decision-making process. It is an accurate diagnostic tool allowing pathological diagnosis to determine the best treatment strategy. However, in some cases, this procedure may fail or may be inappropriate particularly for anterior parasellar lesions. Over these past decades, endoscopy has been widely developed and promoted in many indications. It represents an interesting alternative approach to parasellar lesions with low morbidity when compared to the classic microscopic sub-temporal extradural approach with or without orbito-zygomatic removal. In this chapter, we describe our experience with the endoscopic approach to parasellar lesions. We propose a complete overview of surgical anatomy and describe methods and results of the technique. We also suggest a model of a decision-making tree for the diagnosis and treatment of parasellar lesions.

Closed and open grade I and II tibial shaft fractures treated by reamed intramedullary nailing.

OBJECTIVE: To evaluate the results of closed and open grade I and II tibial shaft fractures treated by reamed nail and unreamed nailing. SUBJECTS AND METHODS: Between 1997 and 2000, 119 patients with tibial shaft fractures were treated with reamed tibial nails. Postoperatively 96 patients (70 closed and 26 grade I and II open fractures) were followed clinically and radiologically for up to 18 months. The nail was inserted either by patellar tendon splitting or by nonsplitting technique. The nail was inserted after overreaming by 1.5 mm. Postoperatively, patients with isolated tibial fracture were mobilized by permitting partial weight bearing on the injured leg for 6 weeks. Patients with associated ankle fractures were allowed to walk with a Sarmiento cast. RESULTS: Postoperatively, 6 (6.3%) patients developed a compartment syndrome after surgery. In 48 (50%) cases, dynamization of the nail was carried out after a mean period of 12 weeks for delayed union. Overall, a 90.6% union was obtained at a mean of 24 weeks without difference between closed or open fractures. Two (2.1%) patients with an open grade II fracture developed a deep infection requiring treatment. A 9.4% rate of malunion was observed. Eight (8.3%) patients developed screw failure without clinical consequences. At the last follow-up, 52% of patients with patellar tendon splitting had anterior knee pain, compared to those (14%) who did not have tendon splitting. CONCLUSION: Reamed intramedullary nail is a suitable implant in treating closed as well as grade I and II open tibial shaft fractures.

E-learning initiatives in forensic interpretation: report on experiences from current projects and outlook

This paper reports on the purpose, design, methodology and target audience of E-learning courses in forensic interpretation offered by the authors since 2010, including practical experiences made throughout the implementation period of this project. This initiative was motivated by the fact that reporting results of forensic examinations in a logically correct and scientifically rigorous way is a daily challenge for any forensic practitioner. Indeed, interpretation of raw data and communication of findings in both written and oral statements are topics where knowledge and applied skills are needed. Although most forensic scientists hold educational records in traditional sciences, only few actually followed full courses that focussed on interpretation issues. Such courses should include foundational principles and methodology - including elements of forensic statistics - for the evaluation of forensic data in a way that is tailored to meet the needs of the criminal justice system. In order to help bridge this gap, the authors' initiative seeks to offer educational opportunities that allow practitioners to acquire knowledge and competence in the current approaches to the evaluation and interpretation of forensic findings. These cover, among other aspects, probabilistic reasoning (including Bayesian networks and other methods of forensic statistics, tools and software), case pre-assessment, skills in the oral and written communication of uncertainty, and the development of independence and self-confidence to solve practical inference problems. E-learning was chosen as a general format because it helps to form a trans-institutional online-community of practitioners from varying forensic disciplines and workfield experience such as reporting officers, (chief) scientists, forensic coordinators, but also lawyers who all can interact directly from their personal workplaces without consideration of distances, travel expenses or time schedules. In the authors' experience, the proposed learning initiative supports participants in developing their expertise and skills in forensic interpretation, but also offers an opportunity for the associated institutions and the forensic community to reinforce the development of a harmonized view with regard to interpretation across forensic disciplines, laboratories and judicial systems.

Decision-making in pediatrics: a practical algorithm to evaluate complementary and alternative medicine for children.

We herein present a preliminary practical algorithm for evaluating complementary and alternative medicine (CAM) for children which relies on basic bioethical principles and considers the influence of CAM on global child healthcare. CAM is currently involved in almost all sectors of pediatric care and frequently represents a challenge to the pediatrician. The aim of this article is to provide a decision-making tool to assist the physician, especially as it remains difficult to keep up-to-date with the latest developments in the field. The reasonable application of our algorithm together with common sense should enable the pediatrician to decide whether pediatric (P)-CAM represents potential harm to the patient, and allow ethically sound counseling. In conclusion, we propose a pragmatic algorithm designed to evaluate P-CAM, briefly explain the underlying rationale and give a concrete clinical example.

Assessment of Medicaid and SCHIP Quality Improvement Activities for the State of Iowa, September, 2008

CMS has established the medicaid Quality Improvement which serves to fulfill the objectives of they Medicaid Quality goal established through the Federal Government Performance and Results At. One of the objectives of the goal calls for the Centers foe Medicare and Medicaid Services to work in partnership with State Medicaid Directors to develop a Nation Medicaid Quality Framework that will articulate broad principles and a common vision of quality for the program.

Leadership Agenda and Strategic Progress Report, 2007-2008

Early Childhood Iowa (ECI) is an alliance of stakeholders in early care, health, and education that affect children age zero to five in the State of Iowa. Its purpose is to support a comprehensive, integrated early care, health and education system for Iowa. All activities of the system are aligned around a common vision for Iowa: Every child, beginning at birth, will be healthy and successful.Membership is voluntary and open to anyone self-identifying as a “stakeholder” in Iowa’s early care, health, and education system. The process for membership will be with as few barriers or constraints as possible. Individuals seeking membership should agree to the vision for an early care, health, and education system in Iowa and to the principles and core beliefs of the ECI Stakeholders. The structure of ECI includes six system component groups that describe the necessary elements of an effective and comprehensive early care, health, and education system, as well as a State Agency Liaison group and a Co-chairs group. Membership in each component group is open to anyone with an interest in the unique responsibilities of a implementing an early care, health and education system.

Interventions motivationnelles: psychose et cannabis [Motivational interventions: psychosis and cannabis]

Cannabis use by people suffering from schizophrenia increase relapse rate and reduce adhesion to treatment. Motivational interventions could reduce cannabis misuse. The motivational interviewing principles and techniques are presented in a concrete way as well as the required adaptations to bypass cognitive deficits associated with schizophrenia.

The construction process of pedagogical knowledge among nursing professors

Didactic knowledge about contents is constructed through an idiosyncratic synthesis between knowledge about the subject area, students' general pedagogical knowledge and the teacher's biography. This study aimed to understand the construction process and the sources of Pedagogical Content Knowledge, as well as to analyze its manifestations and variations in interactive teaching by teachers whom the students considered competent. Data collection involved teachers from an undergraduate nursing program in the South of Brazil, through non-participant observation and semistructured interviews. Data analysis was submitted to the constant comparison method. The results disclose the need for initial education to cover pedagogical aspects for nurses; to assume permanent education as fundamental in view of the complexity of contents and teaching; to use mentoring/monitoring and the value learning with experienced teachers with a view to the development of quality teaching.

Work Organization Practices for Lean Production: A Study in Spanish and Brazilian Manufacturers

This work aims to discuss particular work organization practices in human resources reported as successful by companies adopting lean production principles, and investigate them through real examples observed on manufacturing plants in Spain and Brazil. A set of work organization practices was previously established by one of the authors, through interviews with practitioners of lean production and review of the literature. A series of visits and informal interviews at Spanish and Brazilian automotive parts manufacturers that follow lean production were conducted to verify that the set of policies are indeed practiced.

The role of culture in international students' image formation: the emergence of expected and perceived university image

Tämän tutkimuksen tavoitteena oli selvittää, vaikuttaako kansainvälisen opiskelijan kulttuuritausta opiskelijan odotetun ja koetun yliopistoimagon muodostumiseen. Jotta kulttuurin vaikutuksia yliopistoimagoon voitiin tutkia, tutkimuksessa tunnistettiin yliopistoimagon muodostumiseen oleellisesti vaikuttavat tekijät. Kulttuurin roolia organisaation imagon muodostumisessa ei ole tutkittu aiemmissa tieteellisissä julkaisuissa. Näin ollen tämän tutkimuksen voidaan katsoa edistäneen nykyistä imagotutkimusta. Tutkimuksen kohdeyliopistona oli Lappeenrannan teknillinen yliopisto (LTY). Tutkimuksen empiirinen osa toteutettiin kvantitatiivisena Internet - pohjaisena kyselytutkimuksena tilastollisen analyysin menetelmin. Otos (N=179) koostui kaikista Lappeenrannan teknillisessä yliopistossa lukuvuonna 2005-2006 opiskelleista kansainvälisistä opiskelijoista. Kyselyyn vastasi 68,7 % opiskelijoista. Johtopäätöksenä voidaan todeta, että kulttuurilla ei ole merkittävää vaikutusta yliopistoimagon muodostumiseen. Tutkimuksessa saatiin selville, että yliopiston Internet-sivujen laatu vaikuttaa positiivisesti odotetun yliopistoimagon muodostumiseen, kun taas koettuun yliopistoimagoon vaikuttavat positiivisesti odotettu yliopistoimago, pedagoginen laatu sekä opetusympäristö. Markkinoinnin näkökulmasta tulokset voidaan vetää yhteen toteamalla, että yliopistojen ei tarvitsisi räätälöidä tutkimuksessa tunnistettuja imagoon vaikuttavia tekijöitä eri kulttuureistatulevia opiskelijoita varten.